On this page13 sections
- Ratings and complaints
- Oscar Health vs. competitors
- Pricing
- Step by step
- Oscar Health legitimacy and licensing
- Oscar Health cost
- How Oscar Health plans work
- Oscar Health complaints and how to avoid problems
- Cancelling, appeals and the rules that protect you
- Who should skip Oscar Health
- What customers say
- Alternatives
- FAQ
Oscar Health is a good fit if you buy your own coverage, are comfortable handling most care through an app, and want $0 visits with its 24/7 virtual clinic. It is a real, licensed insurer: a public company (NYSE: OSCR) that reported 2,963,002 members as of June 30, 2026, almost all in individual and small group plans, including ICHRA plans that employers fund. The tradeoff is service: Trustpilot reviewers rate it 1.3 out of 5, and a 2025 Texas exam found late notices, missed peer-to-peer reviews and unpaid late-claim penalties that ended in a $225,000 fine. Check that your doctors and drugs are in the plan for your ZIP code before you enroll.
- Company
- Oscar Health, Inc., New York, NY; publicly traded (NYSE: OSCR); CEO Mark Bertolini2
- Members
- 2,963,002 as of June 30, 2026, up from 2,027,148 a year earlier2
- Where it sells
- Individual and family plans in 20 states, according to Oscar, sold on HealthCare.gov, state marketplaces and Oscar's site1
- Plans
- ACA individual and family plans, condition-focused plans (diabetes, asthma and COPD, menopause, chronic care), Spanish-first Buena Salud plans and employer ICHRA plans; no Medicare Advantage plans listed1
- Virtual care
- $0 Oscar Virtual Care, a 24/7 virtual clinic, as listed October 20261
- 2027 enrollment
- Open Enrollment runs November 1, 2026, to January 15, 2027, per Oscar1
- Regulatory action
- $225,000 Texas Department of Insurance penalty, August 11, 2025, after a quality of care exam3
- Results
- Net income of $361.8 million in the second quarter of 2026 on $4.88 billion of revenue2
Pros
- $0 24/7 virtual clinic visits, as listed by Oscar
- Highly rated member app (4.8 on the App Store)
- Plans built for specific conditions such as diabetes, asthma and COPD
- Profitable and growing, with $361.8 million net income in the second quarter of 2026
- Employer ICHRA option for small businesses
Cons
- 1.3 out of 5 on Trustpilot, mostly over denials and service
- Sold in only 20 states and not every county
- HMO and EPO plans pay little or nothing out of network; check the network type
- $225,000 Texas penalty for utilization review and claim payment violations
- No Medicare Advantage plans listed
Best for: People who buy their own marketplace coverage, are mostly healthy and want to handle care through an app and $0 virtual visits.
Skip it if: You need a wide network, see many specialists or rely on out-of-network doctors.
Oscar Health vs. competitors
| Company | Individual (marketplace) plans | Trustpilot | BBB |
|---|---|---|---|
| Oscar Health | 20 states | 1.3 out of 5 (277 reviews) | A+, not accredited, 86 complaints in 3 years |
| Ambetter (Centene) | 29 states in 2026 | 1.2 out of 5 | Varies by state plan (A+ to A- among plans we checked) |
| UnitedHealthcare | 30 states in 2026; leaving Georgia for 2027 | 1.2 out of 5 | A+, not accredited, 2,539 complaints in 3 years |
| Blue Cross Blue Shield | All 50 states, through 33 local companies | 1.2 out of 5 (association profile) | A+ to B-, by company |
Oscar Health pricing at a glance
What Oscar coverage costs, October 20261
| Item | What you pay | Where to check |
|---|---|---|
| Monthly premium | Set by state, ZIP code, age, metal tier and tobacco use; tax credits lower it if you qualify | HealthCare.gov or your state marketplace |
| Oscar Virtual Care (24/7 virtual clinic) | $0, as listed by Oscar | Plan documents for your plan |
| Deductible and out-of-pocket maximum | Varies by plan; bronze plans have the highest deductibles | Summary of Benefits and Coverage for each plan |
| Employer ICHRA plans | Employer sets the monthly allowance; you pick an Oscar plan | Your employer |
Oscar does not publish one national price. Enhanced federal premium tax credits ended after 2025, so many 2026 and 2027 premiums are higher than before; regular tax credits still apply if your income qualifies.
Oscar Health, step by step
Check that Oscar sells in your county
Enter your ZIP code on HealthCare.gov, your state marketplace or Oscar's site. Oscar sells in 20 states, and not in every county within them.
Compare plans by total yearly cost
Add 12 months of premiums to the deductible and out-of-pocket maximum, then compare against other insurers in your area.
Search your doctors and drugs
Use the plan's provider directory and drug list for the exact plan name. Check the network type: HMO and EPO plans usually do not pay for non-emergency care outside the network.
Enroll during Open Enrollment
For 2027 coverage, Oscar lists November 1, 2026, to January 15, 2027. Outside that window you need a qualifying life event.
Set up the app
Pay premiums, find in-network care, message your care team and book virtual visits in the Oscar app.
Appeal any denial
File an internal appeal first. If Oscar upholds it, you can request an independent external review.
Oscar Health legitimacy and licensing
Yes. Oscar Health, Inc. is a licensed health insurer and a public company that files reports with the SEC. It reported 2,963,002 members as of June 30, 2026, up from 2,027,148 a year earlier, and net income of $361.8 million for the second quarter of 2026. Its plans are sold on HealthCare.gov and state marketplaces, which only list insurers approved by regulators.
Legitimate does not mean trouble-free. In August 2025 the Texas Department of Insurance fined Oscar Insurance Company $225,000 after a quality of care exam of its 2020 to 2021 activity. Examiners found that in 42% of sampled denials Oscar or its contractors did not offer the treating doctor a peer-to-peer review first, that some late claims were paid without required penalties, and that a 2024 report showed 287 claims with $1.67 million in unpaid penalties and interest. Oscar agreed to the order without a hearing.
The BBB rates Oscar A+ but it is not accredited, with 86 complaints in three years.
Oscar Health cost
Oscar does not publish a single price. Your premium depends on your state, ZIP code, age, the metal tier you pick (bronze, silver, gold) and tobacco use. If your income qualifies, a premium tax credit lowers what you pay; HealthCare.gov shows the after-credit price for every Oscar plan in your area.
Enhanced federal tax credits ended after 2025. Oscar’s own SEC filing says this made coverage unaffordable for some people, so expect higher prices than in 2025 unless your income qualifies for the regular credit. Oscar lists $0 visits with its 24/7 virtual clinic, and some plans add $0 primary care or routine labs. Read the Summary of Benefits and Coverage for the deductible and out-of-pocket maximum before you choose.
How Oscar Health plans work
Each Oscar plan lists its network type. HMO and EPO plans generally pay only for in-network care except in emergencies, so check the type before you buy. You shop by ZIP code, pick a plan, and manage it through the Oscar app: ID card, claims, premium payments, provider search and virtual care. Members can message a care team for help finding doctors and checking costs.
Oscar also sells condition-focused plans, including diabetes, asthma and COPD, menopause and chronic care plans, a Spanish-first plan called Buena Salud, and Hy-Vee Health with Oscar in some areas. Employers can fund Oscar plans through an individual coverage HRA (ICHRA). Oscar’s site does not list Medicare Advantage plans.
What customers say about Oscar Health
Recurring themes across the review sites and complaint records listed above, not individual quotes.
Common praise
- A well rated app for ID cards, claims and finding doctors
- $0 virtual urgent care and primary care visits on many plans
- Lower premiums than some local competitors, according to reviewers
- Easy online enrollment
Common complaints
- Claim denials and surprise bills after care members thought was covered
- Long hold times and agents who give conflicting answers
- Prior authorization delays for prescriptions and specialist care
- Narrow networks, with doctors who drop out or do not accept the plan
- High deductibles, even on gold plans
Oscar Health complaints and how to avoid problems
On Trustpilot, 91% of 277 reviews are one star. The repeated themes are claim denials, surprise bills, long hold times, prior authorization delays and doctors who turn out to be out of network. The app itself rates 4.8 out of 5 on the App Store, so most problems are with coverage decisions and phone support rather than the technology.
- Search each doctor, hospital and drug by the exact plan name before enrolling, and screenshot the result.
- Ask whether a test, scan or specialist visit needs prior authorization before you book it.
- Keep every Explanation of Benefits and denial letter.
- If a denial looks wrong, appeal in writing and ask your doctor to request a peer-to-peer review.
Cancelling, appeals and the rules that protect you
Marketplace plans follow the Affordable Care Act. Oscar cannot deny you or charge more for a pre-existing condition, and it must cover essential health benefits. If Oscar denies a claim or a prior authorization, you can file an internal appeal and then ask for an independent external review, whose decision the insurer must follow.
To cancel a marketplace plan, end it through HealthCare.gov or your state marketplace, not only with Oscar, so your tax credit stops correctly. If you have a complaint you cannot resolve, contact your state’s department of insurance. In Texas, the department has already acted against Oscar once.
Who should skip Oscar Health
Oscar is a weak fit if you see several specialists, need a specific hospital system, or travel often and need out-of-network coverage. It is also not an option for Medicare Advantage. If your income is low, check Medicaid or CHIP first, since HealthCare.gov will route you there when you qualify.
Alternatives to Oscar Health
- Your state's Blue Cross Blue Shield plan Usually has the widest local network, which matters if your doctors are not in Oscar's directory. Read review
- Ambetter Another low-premium marketplace insurer worth quoting side by side where both sell plans. Read review
- UnitedHealthcare A national network that helps if you travel or split time between states. Read review
- Medicaid or CHIP If your income is low enough, coverage costs little or nothing, and HealthCare.gov checks your eligibility when you apply.
Oscar Health reviews
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Frequently asked questions
Is Oscar Health a good insurance company?
Oscar is financially stable and its app and $0 virtual care are well liked, but member reviews are poor, with a 1.3 out of 5 Trustpilot score from 277 reviews. It works best for healthy people who mainly need preventive and virtual care. Compare total yearly cost and network fit against other insurers in your ZIP code.
Is Oscar Health legit or a scam?
It is legitimate. Oscar Health is a licensed insurer, trades on the New York Stock Exchange and sells plans on HealthCare.gov and state marketplaces. It reported about 2.96 million members as of June 30, 2026.
What states does Oscar Health cover?
Oscar says it sells individual and family plans in 20 states. It does not sell in every county of those states, so enter your ZIP code on HealthCare.gov or Oscar's site to see if plans are available to you.
Does Oscar Health have out-of-network coverage?
It depends on the plan. HMO and EPO plans usually cover only in-network care except emergencies, while PPO plans include some out-of-network coverage. Check the network type and Summary of Benefits and Coverage before you enroll if you need out-of-network care.
Is Oscar virtual care free?
Oscar lists $0 visits with Oscar Virtual Care, its 24/7 virtual clinic, as of October 2026. Confirm in your plan documents, since benefits can differ by plan and state.
Does Oscar Health offer Medicare Advantage?
Oscar's website does not list Medicare Advantage plans as of October 2026. Its business is individual, family, small group and ICHRA coverage. People on Medicare should compare plans at Medicare.gov.
What is the BBB rating for Oscar Health?
The BBB rates Oscar A+. It is not BBB accredited and shows 86 complaints in the last three years and 54 customer reviews.
Why is Oscar Health so cheap?
Lower premiums usually come with narrower networks and higher deductibles on lower tiers. Tax credits also lower the price for people who qualify. Check the deductible and out-of-pocket maximum, not just the premium.
Has Oscar Health been fined?
Yes. The Texas Department of Insurance fined Oscar Insurance Company $225,000 in August 2025 over utilization review notices, missed peer-to-peer reviews and unpaid late-claim penalties. Oscar's SEC filings also note that past regulatory reviews have led to fines.
How do I cancel Oscar Health?
If you bought through HealthCare.gov or a state marketplace, end the plan there so your tax credit stops. If you bought directly from Oscar, contact Oscar member services at the number on your ID card.
Sources (8)
Facts on this page come from company websites, government agencies and regulators, checked on the dates shown. Editorial standards
- Oscar Health: Home page (20 states, $0 virtual care, 2027 Open Enrollment dates) (accessed October 13, 2026)
- Oscar Health, Inc.: Form 10-Q for the quarter ended June 30, 2026 (SEC) (accessed October 13, 2026)
- Texas Department of Insurance: Consent Order No. 2025-9465, Oscar Insurance Company (accessed October 13, 2026)
- BBB: Oscar business profile (accessed October 13, 2026)
- Trustpilot: Oscar Health (hioscar.com) reviews (accessed October 13, 2026)
- Apple App Store: Oscar Health app (accessed October 13, 2026)
- HealthCare.gov: See plans and prices (accessed October 13, 2026)
- HealthCare.gov: Appealing a health plan decision (accessed October 13, 2026)
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